Anthem Blue Cross Blue Shield

Overview

Anthem Blue Cross Blue Shield, a prominent entity in the insurance industry, operates as a trade name for various independent licensees of the Blue Cross Blue Shield Association. Founded in 1929, the company provides a range of Medicaid services across multiple states, including California, Indiana, Nevada, and New York. Anthem emphasizes adherence to documentation standards and proper coding for claims submissions, as outlined in its reimbursement policies. These policies require the use of industry-standard codes, such as Current Procedure Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, to ensure compliance with medical necessity guidelines. The company also publishes practical guides and checklists aimed at assisting healthcare providers in navigating the claims process and understanding their responsibilities regarding service authorization and reimbursement. Anthem's documentation reflects a commitment to providing clear instructions and resources for both participating and non-participating providers, ensuring that all claims are processed in accordance with established policies and regulations.

Industry